In “Maladies,” James Franco plays James, a 1960s soap opera star who moves into his friend’s beachside house with his mentally disabled sister Patricia, played by Fallon Goodson. After retiring from acting, James is riddled with hypersensitivities and voices in his head that narrate his actions, advise him and ultimately drive him to the point of insanity. His personal delusions are augmented by the instability of his surroundings, namely his deranged sister, sexually ambiguous neighbor and cross-dressing guardian Catherine, played by Catherine Keener.

The film begins with an overture of voiceovers and images that summarize the fragile story. Narrator Ken Scott, who also voices James’ internal monologue, delivers a series of maxims with an air of self-congratulation — “Sometimes it is hard to know where you are going, where you are, what time it is…”

While these statements might be true, they require consequent explanation, something that is never provided. The film is written and directed by Carter, who, like each of his characters, has only a first name and struggles to find a direction. His film floats along slowly, never truly finding a steady course.

There is no plot to the piece, as it is composed of shallow vignettes that rely solely on the dialogue, which itself is written in trite maxims and unanswered questions. There are, however, cleverly crafted sections of the screenplay. For example, in one scene James is visited by his homosexual neighbor Delmar, played by David Strathairn, who struggles to solve a crossword puzzle and must ask James for help.

Here, the befuddling crossword stands in for Catherine’s cross-dressing and Delmar’s own confusion with gender identity. James’ ability to solve the puzzle with ease shows how he can somehow make sense of the chaos around him. This is one of the few effectively poignant scenes of “Maladies,” depicting the human desperation for love and search for personal identity.

The film is pale — shot in washed-out tints that fascinatingly mirror the sickness of its characters. But in this, a grotesque, curious hue of emotions comes to the surface. “Maladies” offers a darkly deranged dream, which entertains and amuses viewers with its air of self-awareness.

The convoluted story is fascinating but seems forced, and the dialogue is driven by character exploration instead of plot and staccato vignettes instead of connected scenes. Carter puts too much trust in the rhetoric of his screenplay to make the film powerful. For this reason, perhaps “Maladies” would function better as a novel, in which the intended power of the words would not be limited by the visuals of the film and would allow room for imagination in the mind of the reader.

A version of this article appeared in the Tuesday, March 25 print edition. Daniel Rubin Lieberson is a contributing writer. Email him at [email protected].